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JK Sun, JF Rizzo; Delayed Visual Recovery Associated with Hyperbaric Oxygen Treatment after Retinal Artery Occlusion . Invest. Ophthalmol. Vis. Sci. 2002;43(13):533.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To report two cases of retinal artery occlusion with severe vision loss which improved significantly but very gradually following hyperbaric oxygen treatment. Methods: Retrospective review of two patients with retinal artery occlusion who underwent hyperbaric oxygen treatment because of severe bilateral visual loss. Results: Patient 1 was a 22 year-old woman with Susac syndrome with 16/20 acuity OU. In February 1997, she awoke with profound vision loss OU. Acuities of 6/200 OD and 4/200 OS were recorded that day. Fundoscopy revealed cilioretinal artery occlusions bilaterally. Beginning eight days after the acute visual loss, she received 11 hyperbaric oxygen treatments (each 90 minutes at 2.5 atmospheres) over 10 days. She also received prednisone (80 mg qd) and Cytoxan. One month later she had 17 treatments over 31 days (same parameters as above). Over four weeks acuities gradually improved to 16/50 OD and 16/20+ OS. Slow improvement continued such that one year later she had 16/25 acuity OU, and two years later she had acuities of 16/20 OD and 16/15 OS. Patient 2 was a 33 year-old man who was monocular post enucleation OS for retinoblastoma and who presented the same day he experienced visual loss OD. His initial acuity OD was hand motions at one foot. Fundoscopy revealed central retinal artery occlusion. Treatment with hyperbaric oxygen (using the above parameters) was begun 2 days later. He received 17 treatments over nine days. Over one month his acuity OD gradually improved to 6/200. Goldmann visual field testing showed significant expansion of his visual field from an initial V4e isopter extending 25º in all directions to one that extended 60º temporally and 40º nasally and inferiorly. Conclusions: Occlusion of the central retinal or cilioretinal arteries usually results in profound, irreversible visual loss. Our patients experienced significant improvement weeks after their arterial occlusive episodes. Hyperbaric oxygen treatment may be a valuable option in the management of ischemic retinal disease, especially given the lack of other effective treatments. These cases are anecdotal, but we are impressed by the unusual improvement of acuity and visual fields in association with hyperbaric oxygen therapy.
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